Skip to main content

Advertisement

SpringerLink
Log in

Role of Social Network Dimensions in the Transition to Injection Drug Use: Actions Speak Louder than Words

  • Original Paper
  • Published:
AIDS and Behavior Aims and scope Submit manuscript

Abstract

The objective of this study was to examine the influences of social network factors, particularly social support and norms, in the transition from non-injection heroin and/or opiate use to heroin-injection, which is one of the leading causes of the spread of HIV/AIDS in China. Respondent-driven sampling was used to recruit young heroin and/or opiate users in an egocentric network study in Yunnan, China. Multivariate logistic regression using hierarchical combinations of candidate variables was used to analyze network factors for the injection transition. A total of 3,121 social network alters were reported by 403 egos with an average network size of eight. Fifty-eight percent of egos transitioned to heroin-injection from non-injection. This transition was associated with having a larger sex network size, a larger number of heroin injectors in one’s network, and a higher network density. The findings enhance our understanding of the influence of social network dimensions on the transition to injection drug use. Accordingly, the development of interventions for heroin and/or opiate users in China should consider social network characteristics.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Wu Z, Wang Y. Introduction: China meets new AIDS challenges. J Acquir Immune Defic Syndr. 2010;53(Suppl 1):S1–3.

    PubMed  Google Scholar 

  2. Wang L, Wang N, Li D, et al. The 2007 estimates for people at risk for and living with HIV in China: progress and challenges. J Acquir Immune Defic Syndr. 2009;50(4):414–8.

    Article  PubMed  Google Scholar 

  3. Jia M, Luo H, Ma Y, et al. The HIV epidemic in Yunnan Province, China, 1989–2007. J Acquir Immune Defic Syndr. 2010;53(Suppl 1):S34–40.

    PubMed  Google Scholar 

  4. Liu H, Grusky O, Li X, Ma E. Drug users: a potentially important bridge population in the transmission of sexually transmitted diseases, including AIDS, in China. Sex Transm Dis. 2006;33(2):111–7.

    Article  PubMed  Google Scholar 

  5. Lu L, Fang Y, Wang X. Drug abuse in China: past, present and future. Cell Mol Neurobiol. 2008;28(4):479–90.

    Article  PubMed  Google Scholar 

  6. Lai S, Chen J, Celentano D, et al. Adoption of injection practices in heroin users in Guangxi Province, China. J Psychoact Drugs. 2000;32(3):285–92.

    Article  CAS  Google Scholar 

  7. Chamala D, Chamala J, Dabin W, Delin H, Rennes N. Transition to injection and sharing of needles/syringes: potential for HIV transmission among heroin users in Chengdu, China. Addict Behav. 2006;31(4):697–701.

    Article  Google Scholar 

  8. Neaigus A, Friedman SR, Curtis R, et al. The relevance of drug injectors’ social and risk networks for understanding and preventing HIV infection. Soc Sci Med. 1994;38(1):67–78.

    Article  PubMed  CAS  Google Scholar 

  9. Phillips M, Pearson V. Coping in Chinese communities: the need for a research agenda. In: Bond M, editor. Chinese psychology. Hong Kong: Oxford University Press; 1996. p. 429–40.

    Google Scholar 

  10. Triandis H. Self and social behavior in differing cultural contexts. Psychoanal Rev. 1989;96(3):269–89.

    Google Scholar 

  11. Wasserman S, Galaskiewicz J. Advances in social network analysis: research in the social and behavioral sciences. Thousands Oaks: Sage Publications; 1994.

    Google Scholar 

  12. Knowlton AR, Hua W, Latkin C. Social support networks and medical service use among HIV-positive injection drug users: implications to intervention. AIDS Care. 2005;17(4):479–92.

    Article  PubMed  CAS  Google Scholar 

  13. Miller M, Neaigus A. Networks, resources, and risk among women who use drugs. Soc Sci Med. 2001;52(6):967–78.

    Article  PubMed  CAS  Google Scholar 

  14. Valente T. Social network influences on adolescent substance use: an introduction. Connections. 2003;25(2):11–6.

    Google Scholar 

  15. Hurd GS, Pattison EM, Llamas R. Models of social network intervention. Contemp Fam Ther. 1981;3(4):246–57.

    Google Scholar 

  16. Cohen S, Wills TA. Stress, social support, and the buffering hypothesis. Psychol Bull. 1985;98(2):310–57.

    Article  PubMed  CAS  Google Scholar 

  17. Zapka JG, Stoddard AM, McCusker J. Social network, support and influence: relationships with drug use and protective AIDS behavior. AIDS Educ Prev. 1993;5(4):352–66.

    PubMed  CAS  Google Scholar 

  18. Friedman SR, Aral S. Social networks, risk-potential networks, health, and disease. J Urban Health. 2001;78(3):411–8.

    Article  PubMed  CAS  Google Scholar 

  19. Ajzen I. The theory of planned behavior. Organ Behav Hum Decis Process. 1991;50(2):179–211.

    Article  Google Scholar 

  20. Borsari B, Carey KB. Descriptive and injunctive norms in college drinking: a meta-analytic integration. J Stud Alcohol. 2003;64(3):331–41.

    PubMed  Google Scholar 

  21. Sheeran P, Abraham C, Orbell S. Psychosocial correlates of heterosexual condom use: a meta-analysis. Psychol Bull. 1999;125(1):90–132.

    Article  PubMed  CAS  Google Scholar 

  22. Hawkins WE, Latkin C, Mandel W, Oziemkowska M. Do actions speak louder than words? Perceived peer influences on needle sharing and cleaning in a sample of injection drug users. AIDS Educ Prev. 1999;11(2):122–31.

    PubMed  CAS  Google Scholar 

  23. Bravo MJ, Barrio G, de la Fuente L, Royuela L, Domingo L, Silva T. Reasons for selecting an initial route of heroin administration and for subsequent transitions during a severe HIV epidemic. Addiction. 2003;98(6):749–60.

    Article  PubMed  Google Scholar 

  24. Neaigus A, Miller M, Frajzyngier V, Friedman SR, Des Jarlais DC. Transitions to injecting drug use among non-injecting heroin users: social network influence and individual susceptibility. J Acquir Immune Defic Syndr. 2006;41(4):493–503.

    Article  PubMed  Google Scholar 

  25. Qian ZH, Vermund SH, Wang N. Risk of HIV/AIDS in China: subpopulations of special importance. Sex Transm Infect. 2005;81(6):442–7.

    Article  PubMed  CAS  Google Scholar 

  26. Nurco DN, Bonito AJ, Lerner M, Balter MB. Studying addicts over time: methodology and preliminary findings. Am J Drug Alcohol Abuse. 1975;2(2):183–96.

    Article  PubMed  CAS  Google Scholar 

  27. Hser YI, Anglin MD, McGlothlin W. Sex differences in addict careers. 1 Initiation of use. Am J Drug Alcohol Abuse. 1987;13(1–2):33–57.

    Article  PubMed  CAS  Google Scholar 

  28. Latkin CA, Forman V, Knowlton A. Concordance between drug users’ and their network members’ reported drug use and HIV status: implications to HIV prevention. In: Levy JA, Pescosolido BA, editors. Social network and health. Amsterdan: Elsevier Science Ltd; 2002. p. 151–64.

    Chapter  Google Scholar 

  29. Anthony J, Vlahov D, Celentano D, et al. Self-report interview data for a study of HIV-1 infection among intravenous drug users: description of methods and preliminary evidence on validity. J Drug Issues. 1991;21(4):739–57.

    Google Scholar 

  30. Neaigus A, Friedman SR, Jose B, et al. High-risk personal networks and syringe sharing as risk factors for HIV infection among new drug injectors. J Acquir Immune Defic Syndr Hum Retrovirol. 1996;11(5):499–509.

    Article  PubMed  CAS  Google Scholar 

  31. Liu H, Feng T, Liu H, et al. Egocentric networks of Chinese men who have sex with men: network components, condom use norms and safer sex. AIDS Patient Care STDS. 2009;23(10):885–93.

    Article  PubMed  Google Scholar 

  32. Norbeck JS, Lindsey AM, Carrieri VL. Further development of the Norbeck social support questionnaire: normative data and validity testing. Nurs Res. 1983;32(1):4–9.

    Article  PubMed  CAS  Google Scholar 

  33. Heckathorn DD. Extensions of respondent-driven sampling: analyzing continuous variables and controlling for differential recruitment. Sociol Methodol. 2007;37(1):151–208.

    Article  Google Scholar 

  34. Jenness SM, Begier EM, Neaigus A, Murrill CS, Wendel T, Hagan H. Unprotected anal intercourse and sexually transmitted diseases in high-risk heterosexual women. Am J Public Health. 2011;101(4):745–50.

    Article  PubMed  Google Scholar 

  35. van Ameijden EJ, Coutinho RA. Large decline in injecting drug use in Amsterdam, 1986–1998: explanatory mechanisms and determinants of injecting transitions. J Epidemiol Community Health. 2001;55(5):356–63.

    Article  PubMed  Google Scholar 

  36. Valente TW. Network models and methods for studying the diffusion of innovations. In: Carrington PJ, Scott J, Wasserman W, editors. Models and methods in social network analysis. New York: Cambridge University Press; 2005. p. 98–116.

    Google Scholar 

  37. Nock MK. Actions speak louder than words: an elaborated theoretical model of the social functions of self-injury and other harmful behaviors. Appl Prev Psychol. 2008;12:159–68.

    Article  PubMed  Google Scholar 

  38. Oosteveen T, Knibbe R, De Vries H. Social influences on young adults’ alcohol consumption: norms, modeling, pressure, socializing, and conformity. Addict Behav. 1996;21(2):187–97.

    Article  Google Scholar 

  39. Davey-Rothwell MA, Latkin C, Tobin K. Longitudinal analysis of the relationship between perceived norms and sharing injection paraphernalia. AIDS Behav. 2010;14(4):878–84.

    Article  PubMed  Google Scholar 

  40. Lu X. An interface between individualistic and collectivistic orientations in Chinese cultural values and social relations. Howard J Commun. 1998;9:91–107.

    Article  Google Scholar 

  41. Davey-Rothwell MA, Latkin CA. HIV-related communication and perceived norms: an analysis of the connection among injection drug users. AIDS Educ Prev. 2007;19(4):298–309.

    Article  PubMed  Google Scholar 

  42. Goel S, Salganik MJ. Assessing respondent-driven sampling. Proc Natl Acad Sci USA. 2010;107(15):6743–7.

    Article  PubMed  CAS  Google Scholar 

  43. Kelly JA, St Lawrence JS, Diaz YE, et al. HIV risk behavior reduction following intervention with key opinion leaders of population: an experimental analysis. Am J Public Health. 1991;81(2):168–71.

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgments

This work was supported by a research grant (R21 DA023893-01A1) from NIH-NIDA. It was awarded to Hongjie Liu and Jianhua Li. We are grateful to the staff from Yunnan Institute of Drug Abuse for their participation in the study, and to all the participants who gave so willingly of their time to provide the study data.

Author information

Authors and Affiliations

  1. Department of Epidemiology and Community Health, Virginia Commonwealth University, 830 E. Main Street, Suite 5034, 980212, Richmond, VA, 23298, USA

    Nana Koram, Hongjie Liu, Jian Li & Jennifer Nield

  2. Yunnan Institute for Drug Abuse, Kunming, Yunnan, China

    Jianhua Li & Jian Luo

Authors
  1. Nana Koram
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Hongjie Liu
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Jianhua Li
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Jian Li
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Jian Luo
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Jennifer Nield
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Hongjie Liu.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Koram, N., Liu, H., Li, J. et al. Role of Social Network Dimensions in the Transition to Injection Drug Use: Actions Speak Louder than Words. AIDS Behav 15, 1579–1588 (2011). https://doi.org/10.1007/s10461-011-9930-1

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10461-011-9930-1

Keywords

Search

Navigation